title: Use of anti-diabetic drugs and glycaemic control in type 2 diabetes-tThe Hong Kong Diabetes Registry.
abstract: In this report, we examined the usage of anti-diabetic treatments including oral anti-diabetic drug (OAD) and/or insulin and their combination from baseline data of a consecutive cohort of 7549 Chinese type 2 diabetic subjects in the Hong Kong Diabetes Registry. Pattern of usage of anti-diabetic treatment and corresponding glycemic control was analyzed. OAD failure was defined as the need to add insulin to maintain glycemic target (glycated hemoglobin, HbA(1c) level<7%) with or without continuation of OAD. There were 4109 [54.4%] women and 3440 [45.6%] men (age: median 57.0 years; range 13-92 years). The mean HbA(1c) level was 7.7+/-1.8% with 39.7% attaining glycemic target. Long disease duration was associated with more complex regimens and the respective rates of OAD failure requiring insulin use were 23.7%, 39.3%, 57.1% and 75.9% in those with disease duration <5 years, 5-9.9 years, 10-19.9 years and > or =20 years (p<0.001). In conclusion, in a clinic-based type 2 diabetic population, 39.7% attained glycemic target with HbA(1c)<7%. Long disease duration and complexity of treatment regimens were associated with suboptimal glycemic control. Early intensification of therapy and system improvement are needed to enhance the effectiveness of these drugs in clinical practice.
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Peter C Y
authors.initials: PC
authors.lastname: Tong
authors.forename: Gary T C
authors.initials: GT
authors.lastname: Ko
authors.forename: Wing-Yee
authors.initials: WY
authors.lastname: So
authors.forename: Sau-Chu
authors.initials: SC
authors.lastname: Chiang
authors.forename: Xilin
authors.initials: X
authors.lastname: Yang
authors.forename: Alice P S
authors.initials: AP
authors.lastname: Kong
authors.forename: Risa
authors.initials: R
authors.lastname: Ozaki
authors.forename: Ronald C W
authors.initials: RC
authors.lastname: Ma
authors.forename: Clive S
authors.initials: CS
authors.lastname: Cockram
authors.forename: Chun-Chung
authors.initials: CC
authors.lastname: Chow
authors.forename: Juliana C N
authors.initials: JC
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006723:Hong Kong; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012042:Registries; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin